The Management of the Open Abdomen in Trauma and Emergency General Surgery: Part 1—Damage Control

Diaz, José J.; Cullinane, Daniel C.; Dutton, William D.; Jerome, Rebecca N; Bagdonas, Richard; Bilaniuk, Jarolslaw O.; Collier, Bryan R.; Como, John J.; Cumming, J.; Griffen, Maggie; Gunter, Oliver L.; Kirby, John P.; Lottenburg, Larry; Mowery, Nathan T.; Riordan, William P.; Martin, Niels D.; Platz, Jon; Stassen, Nicole A.; Winston, Eleanor

doi:10.1097/ta.0b013e3181da0da5

Cited by 156 publications

(140 citation statements)

References 70 publications

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“…Our experimental rat model of ACS resembles the clinical picture of a human patient during the early post-operative course after damage control surgery [15]. This ACS model led to increased intrathoracic pressure with lung parenchyma impairment, resulting in interstitial oedema, alveolar collapse and haemorrhage, and neutrophil infiltration.…”

Section: Discussionmentioning

confidence: 99%

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Early impact of abdominal compartment syndrome on liver, kidney and lung damage in a rodent model

Lima¹,

Silva²,

Capelozzi³

et al. 2017

Anaesthesiol Intensive Ther

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Background: Abdominal compartment syndrome (ACS) sometimes occurs in critically ill patients following damage control surgery. The purpose of the present study was to develop a model of ACS and to evaluate its pathologic impact on liver, kidney, and lung morphology. Methods: Twenty Wistar rats (mass 300-350 g) were randomly divided into four groups: 1) intra-abdominal hypertension (IAH): a laparotomy was performed and the abdomen packed with cotton until an intra-abdominal pressure (IAP) of 15 mm Hg was reached; 2) hypovolemia (HYPO): blood was withdrawn until a mean arterial pressure ~60 mm Hg was reached; 3) IAH + HYPO (to resemble clinical ACS); and 4) sham surgery. After 3 hours of protective mechanical ventilation, the animals were euthanized and the liver, kidney and lungs removed to examine the degree of tissue damage. Results: IAH resulted in the following: oedema and neutrophil infiltration in the kidney; necrosis, congestion, and microsteatosis in the liver; and alveolar collapse, haemorrhage, interstitial oedema, and neutrophil infiltration in the lungs. Furthermore, IAH was associated with greater cell apoptosis in the kidney, liver and lungs compared to sham surgery. HYPO led to oedema and neutrophil infiltration in the kidney. The combination of IAH and HYPO resulted in all the aforementioned changes in lung, kidney and liver tissue, as well as exacerbation of the inflammatory process in the kidney and liver and kidney cell necrosis and apoptosis. Conclusions: Intra-abdominal hypertension by itself is associated with kidney, liver and lung damage; when combined with hypovolemia, it leads to further impairment and organ damage.

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Section: Discussionmentioning

confidence: 99%

“…Although current treatment of ACS is based on consensus definitions and recommendations, several questions [12,15]. Our experimental rat model of ACS resembles the clinical picture of a human patient during the early post-operative course after damage control surgery [15].…”

Section: Discussionmentioning

confidence: 99%

Early impact of abdominal compartment syndrome on liver, kidney and lung damage in a rodent model

Lima¹,

Silva²,

Capelozzi³

et al. 2017

Anaesthesiol Intensive Ther

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“…Incluyeron estudios prospectivos y retrospectivos y excluyeron las revisiones y los informes de casos. De 1200 artículos seleccionaron 95 y los diecisiete autores del trabajo los analizaron con criterios de evidencia bien definidos por la Asociación de Trauma 88 . Esta evaluación se dividió en dos partes.…”

Section: A) Indicación Del Control De Daños En Traumaunclassified

“…Del total de casos, entre un 10 y un 20% son cuadros graves y de estos un 30% muere en el transcurso de la primera semana de evolución, por distintas complicaciones y falla multiorgánica 38,69,[80][81][82][83][84][85][86][87][88][89] . Los factores de riesgo de mortalidad son la infección de la necrosis pancreática (NPI), la coexistencia de HIA y el SCA.…”

Section: B) Pancreatitis Aguda Grave (Pag)/necrosis Pancreática Infecunclassified

Manejo Del Abdomen Abierto: Desde La Operación Inicial Al Cierre Definitivo

Latif¹

2017

Rev Argent Cirug

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“…As described by the Open Abdomen Advisory Panel, 6 the open abdomen technique (OAT) [7][8][9] is widely utilized in life-threatening trauma, intra-abdominal sepsis and abdominal compartment syndrome. The OAT poses a variety of critical care challenges, inclusive of surgical, metabolic and nutritional complications; as well as infections both local and systemic.…”

Section: Introductionmentioning

confidence: 99%

Challenges of Complex Open Abdominal Wound Management in Trauma: A Novel Use of Chitosan and Hyaluronic Acid as a 3-Dimensional Scaffold to Overcome Resilient Open Abdomen Infections

Luttrell¹,

Khashwj²,

Ingalls³

et al. 2015

Journal of the American College of Clinical Wound Specialists

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The Management of the Open Abdomen in Trauma and Emergency General Surgery: Part 1—Damage Control

Abstract: The open abdomen technique remains a heroic maneuver in the care of the critically ill trauma or surgical patient. For the best outcomes, a protocol for the indications, temporary abdominal closure, staged abdominal reconstruction, and nutrition support should be in place.

Cited by 156 publications

References 70 publications

Early impact of abdominal compartment syndrome on liver, kidney and lung damage in a rodent model

Early impact of abdominal compartment syndrome on liver, kidney and lung damage in a rodent model

Manejo Del Abdomen Abierto: Desde La Operación Inicial Al Cierre Definitivo

Challenges of Complex Open Abdominal Wound Management in Trauma: A Novel Use of Chitosan and Hyaluronic Acid as a 3-Dimensional Scaffold to Overcome Resilient Open Abdomen Infections

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